After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promisi...After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promising intervention to address these deficits.However,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted interventions.To address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination.Twenty-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand dexterity.We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly subtask.Importantly,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks.Notably,the observed neural response patterns varied depending on the specific subtask.In the unaffected hand task,the differences were primarily observed in the ipsilesional hemisphere.In contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,respectively.While significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual tasks.This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural responses.The findings also suggest that patients w展开更多
目的:采用Meta分析系统评价单侧(Unilateral)、双侧(Bilateral)训练对下肢最大力量不同效应指标影响的效果,为促进训练者在实践中的应用提供理论依据。方法:检索Web of science、Google Scholar、CKNI、PubMed等数据库中关于单、双侧训...目的:采用Meta分析系统评价单侧(Unilateral)、双侧(Bilateral)训练对下肢最大力量不同效应指标影响的效果,为促进训练者在实践中的应用提供理论依据。方法:检索Web of science、Google Scholar、CKNI、PubMed等数据库中关于单、双侧训练对下肢最大力量干预的随机对照实验文献,对纳入文献的筛选、数据提取及质量评价由2名研究者独立完成,使用Reviewer Manager5.0、Stata SE12.0进行效应量合并、敏感性分析、亚组分析及异质性检验和回归、偏倚分析。结果:9篇文献纳入Meta分析,分析总样本量186人。Meta分析结果显示:(1)单侧训练对1RM深蹲[MD=0.91,95%CI(-2.50,4.33),P=0.60]不具有显著的统计学意义,但单侧训练[MD=10.6,95%CI(7.32,13.88),P<0.00001]和双侧训练[MD=10.88,95%CI(7.90,13.86),P<0.00001]在独立基线随访效应上表现出在统计学上的显著提高,单侧训练对1RM深蹲影响相对较大;(2)单侧训练对1RM保加利亚深蹲[MD=3.31,95%CI(0.12,6.51),P=0.04]具有显著影响。结论:单侧训练比双侧训练更能显著提高1RM保加利亚深蹲。单侧训练提高1RM深蹲没有显著性差异。单侧和双侧训练组内森林图对比,双侧训练提升1RM深蹲效果优于单侧训练。双侧训练对于1RM深蹲有效性的研究证据需在未来进一步发现。展开更多
基金supported by the National Key R&D Program of China,No.2020YFC2004202(to DX).
文摘After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promising intervention to address these deficits.However,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted interventions.To address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination.Twenty-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand dexterity.We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly subtask.Importantly,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks.Notably,the observed neural response patterns varied depending on the specific subtask.In the unaffected hand task,the differences were primarily observed in the ipsilesional hemisphere.In contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,respectively.While significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual tasks.This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural responses.The findings also suggest that patients w
